Evidence-Based Use of Prophylactic Anticholinergic Medication in Combination with Antipsychotic Pharmacotherapy in an Acute Inpatient Psychiatric Setting

Persistent Link:
http://hdl.handle.net/10150/614026
Title:
Evidence-Based Use of Prophylactic Anticholinergic Medication in Combination with Antipsychotic Pharmacotherapy in an Acute Inpatient Psychiatric Setting
Author:
Chyan, Vivian; Shell, Megan; Goldstone, Lisa
Affiliation:
College of Pharmacy, The University of Arizona
Issue Date:
2015
Rights:
Copyright © is held by the author.
Collection Information:
This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Associate Librarian and Clinical Instructor, Pharmacy Practice and Science, jenmartin@email.arizona.edu.
Publisher:
The University of Arizona.
Abstract:
Objectives: The study aimed to increase EPS risk factor assessment when prescribers order prophylactic anticholinergics with antipsychotics. An evidence-based pharmacist checklist card was developed to aid in this decision making process. Methods: A retrospective chart review of patients admitted to the acute inpatient psychiatry units at an academic medical center was conducted to determine baseline prophylactic anticholinergic prescribing habits over a two-month period. Charts were included if the patient was at least 18 years old and ordered at least one scheduled antipsychotic during the admission. An educational intervention session introduced the pharmacist checklist card and shared baseline findings. Post-intervention data was collected during a two-month period following the intervention. The percentage of prophylactic anticholinergic orders based upon pharmacist checklist card parameters pre and post-intervention was analyzed using chi-square test. Results: There was a significant decrease in the total percentage of orders for prophylactic anticholinergics from 72.7% in the pre-intervention period to 50.8% in the post-intervention period (p<0.001). Significant changes in the percentage of orders for prophylactic anticholinergics were also found for patients at no-to-low risk for EPS (56.4% versus 31.8%, p=0.014) and at low-to-moderate risk for EPS (79.6% versus 50.8%, p=0.003). There were no significant changes observed in the percentage of orders for prophylactic anticholinergics for patients at moderate-to-high risk for EPS. A lower percentage of patients prescribed a prophylactic anticholinergic experienced adverse effects in the post versus the pre-intervention period (52.31% versus 75.27%, p=0.003). Conclusions: Significant differences were found between pre and post-intervention anticholinergic medication prescribing habits. This suggests that increased patient risk factor assessment in the form of a pharmacist checklist card is effective in decreasing orders for prophylactic anticholinergic medications not clinically indicated and reducing the incidence of adverse effects.
Description:
Class of 2015 Abstract
Keywords:
Evidence-Based; Prophylactic Anticholinergic Medication; Antipsychotic Pharmacotherapy; Psychiatric
Advisor:
Goldstone, Lisa

Full metadata record

DC FieldValue Language
dc.contributor.advisorGoldstone, Lisaen
dc.contributor.authorChyan, Vivianen
dc.contributor.authorShell, Meganen
dc.contributor.authorGoldstone, Lisaen
dc.date.accessioned2016-06-21T22:45:50Z-
dc.date.available2016-06-21T22:45:50Z-
dc.date.issued2015-
dc.identifier.urihttp://hdl.handle.net/10150/614026-
dc.descriptionClass of 2015 Abstracten
dc.description.abstractObjectives: The study aimed to increase EPS risk factor assessment when prescribers order prophylactic anticholinergics with antipsychotics. An evidence-based pharmacist checklist card was developed to aid in this decision making process. Methods: A retrospective chart review of patients admitted to the acute inpatient psychiatry units at an academic medical center was conducted to determine baseline prophylactic anticholinergic prescribing habits over a two-month period. Charts were included if the patient was at least 18 years old and ordered at least one scheduled antipsychotic during the admission. An educational intervention session introduced the pharmacist checklist card and shared baseline findings. Post-intervention data was collected during a two-month period following the intervention. The percentage of prophylactic anticholinergic orders based upon pharmacist checklist card parameters pre and post-intervention was analyzed using chi-square test. Results: There was a significant decrease in the total percentage of orders for prophylactic anticholinergics from 72.7% in the pre-intervention period to 50.8% in the post-intervention period (p<0.001). Significant changes in the percentage of orders for prophylactic anticholinergics were also found for patients at no-to-low risk for EPS (56.4% versus 31.8%, p=0.014) and at low-to-moderate risk for EPS (79.6% versus 50.8%, p=0.003). There were no significant changes observed in the percentage of orders for prophylactic anticholinergics for patients at moderate-to-high risk for EPS. A lower percentage of patients prescribed a prophylactic anticholinergic experienced adverse effects in the post versus the pre-intervention period (52.31% versus 75.27%, p=0.003). Conclusions: Significant differences were found between pre and post-intervention anticholinergic medication prescribing habits. This suggests that increased patient risk factor assessment in the form of a pharmacist checklist card is effective in decreasing orders for prophylactic anticholinergic medications not clinically indicated and reducing the incidence of adverse effects.en
dc.language.isoen_USen
dc.publisherThe University of Arizona.en
dc.rightsCopyright © is held by the author.en
dc.subjectEvidence-Baseden
dc.subjectProphylactic Anticholinergic Medicationen
dc.subjectAntipsychotic Pharmacotherapyen
dc.subjectPsychiatricen
dc.titleEvidence-Based Use of Prophylactic Anticholinergic Medication in Combination with Antipsychotic Pharmacotherapy in an Acute Inpatient Psychiatric Settingen_US
dc.typetexten
dc.typeElectronic Reporten
dc.contributor.departmentCollege of Pharmacy, The University of Arizonaen
dc.description.collectioninformationThis item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Associate Librarian and Clinical Instructor, Pharmacy Practice and Science, jenmartin@email.arizona.edu.en
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